NPIMap

Organization Active NPI

Glenn Medical Center, LLC

Doing business as Glenn Family Medical Group

  • Rural Health Clinic/Center
  • Willows, CA
National Provider Identifier
1346283017
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
23000001 Issued in CA
Legal business name
GLENN MEDICAL CENTER, LLC
Doing business as
Glenn Family Medical Group
Glenn Medical Center
Practice address
130 N Enright Ave
Willows, CA 95988-2716
Phone
(530) 934-1800
Fax
(530) 934-1818
NPI assigned
Jun 13, 2006
Last updated
Nov 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tammy Jean Thompson
Title
VP Finance/Cfo
Phone
(209) 287-6308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 23000001 CA Primary

Addresses

Primary practice location

130 N Enright Ave
Willows, CA 95988-2716

Mailing address

1133 W Sycamore St
Willows, CA 95988-2601
Phone (530) 934-1800

Other identifiers 1

IdentifierTypeStateIssuer
RHM08572GMedicaidCA

Other names 3

  • GLENN FAMILY MEDICAL GROUP Doing business as
  • GLENN MEDICAL CENTER Doing business as
  • GLENN MEDICAL CENTER, INC. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Tax ID family
Enloe General Colorectal S18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

130 N Enright Ave
Willows, CA 95988
Phone (530) 934-1800

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jun 1, 2025 Change of OwnershipThis provider was the seller Glenn Family Medical GroupCCN 058572, CA, NPI 1760272991

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1346283017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 W SYCAMORE ST",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882601",
            "telephone_number": "530-934-1800",
            "fax_number": "530-934-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N ENRIGHT AVE",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882716",
            "telephone_number": "530-934-1800",
            "fax_number": "530-934-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "VP FINANCE/CFO",
        "authorized_official_telephone_number": "209-287-6308"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "23000001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08572G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLENN FAMILY MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GLENN FAMILY MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GLENN MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GLENN MEDICAL CENTER, INC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Willows, CA

Sources for this page

Verify at the official NPI Registry.